• Roy Shelburne

    Video: Another Update on the Healthcare Fraud Case of Dentist Dr. Roy S. Shelburne

    Well, this is not exactly what Dr. Shelburne agreed to in writing (consent order) when he surrendered his dental license. He agreed to never contest the findings of fact.

    You can read the documents here.

    I will let the reader pass judgment on Dr. Shelburne but I cannot help but think this little exercise and the one here are nothing but jury pool spin. His son now owns his former dental practice and Dr. Shelburne senior faces a federal civil trial which might cost him all of the proceeds of such a sale/transfer – and the remainder of his assets.

    Also, it is not beyond the realm of possibility that Dr. Shelburne will apply to have his dental license reinstated.

    Of course, dentists must document their records but the egregious nature of the abuse here is far and way beyond anything I have ever seen or reviewed.

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    Update on the Case of Dr. Roy S. Shelburne

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison But U.S. Attorney Wants More

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court – Part Two

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed

    The Case of Dentist Roy S. Shelburne

  • Roy Shelburne

    Update on the Case of Dr. Roy S. Shelburne

    Dental Economics managing editor Kevin Henry speaks with the Virginia dentist about his arrest, time in prison, recent release, and advice to his peers.

    Here is a follow-up on the Dr. Roy Shelburne story I covered a couple of years ago.

    I agree about record keeping but, we in the dental profession, are taught this at an early age in dental school and is reinforced throughout our careers via continuing education.

    Strange, but it seems to me that Dr. Shelburne is not the least bit contrite or remorseful about his dental activity that led to his conviction. Perhaps this is why the Feds pushed so hard for punishment in this case.

    Just saying…….

    Update:

    Here is the Virginia Department of Health Professions adjudication of Dr. Shelburn’s dental license and Consent Order of July 15, 2008

    The link above requires a search so here are the documents:

    First, the Notice:

    Shelburne 2 0401005798Notice05202008(2)

    And, then the Consent Order:

    Shelburne 1 0401005798Order07152008

    Previous:

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison But U.S. Attorney Wants More

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court – Part Two

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed

    The Case of Dentist Roy S. Shelburne


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  • Dentistry,  Roy Shelburne

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison But U.S. Attorney Wants More

    roysshelburne

    Dentist Dr. Roy S. Shelburne, D.D.S. of Virginia

    The federal prosecutors are NOT satisfied sending Virginia dentist, Dr. Roy S. Shelburne, D.D.S. to the POKIE for two years.

    A U.S. attorney is appealing a federal district court judge’s decision to vacate a dentist’s convictions for money laundering, setting up a legal battle over a federal statute that was recently interpreted by the U.S. Supreme Court.

    A notice of appeal has been filed in the U.S. Court of Appeals for the Fourth Circuit. The appeal from Acting U.S. Attorney Julia C. Dudley indicates the government is pushing back against an ambiguous Supreme Court decision that in some money laundering cases holds prosecutors to a higher burden of proof.

    Let’s see:

    • Dr. Shelburne will be sent to federal prison for two years and/or a fraction thereof.
    • Dr. Shelburne has lost his dental license, his dental practice and his livelihood.
    • Dr. Shelburne more than likely has forfeited alot of his assets in legal fees fighting the government.

    Yet, the federal prosecutors want more.

    The question to ask at this point is why?

    Previous:

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court – Part Two

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed


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  • Dentistry,  Roy Shelburne

    The Case of Dr. Roy S. Shelburne – Convicted and Sentenced to Two Years in Federal Prison

    roysshelburne

    Dentist Dr. Roy S. Shelburne, D.D.S. of Virginia

    Flap has been away from this story for a few weeks. So, let’s catch up.

    On July 10, 2008, Pennington Gap, Virginia dentist Dr. Roy S. Shelburne, D.D.S. was sentenced to two years in prison for three felony convictions of racketeering, defrauding Medicaid and structuring a financial transaction.

    Judge James P. Jones sentenced Roy Shelburne to two years for each of the felony counts, which will run concurrently. Shelburne was also fined $75,000, and must pay nearly $18,000 in restitution to state Medicaid.

    The sentence comes a week after the judge threw out all seven of Shelburne’s convictions for money laundering, based on a recent interpretation of the statute by the U.S. Supreme Court. Previously, Shelburne had faced up 120 years in prison and a $1.25 million fine.

    ShelburnOffice

    The dental office of Roy S. Shelburne, D.D.S.

    At the sentencing hearing, the federal prosecution led by U.S. Attorney Tony Giomo, presented a computer-generated statistical estimate that Shelburne likely bilked Medicaid of about $263,000.

    The actual amount of money, as well as the number of patients overbilled, remains unknown.

    But Giorno’s team claimed to have filled in the gaps with a statistical model based on the files of patients known to have been overcharged.

    Judge Jones said he would need more information than readily available to accept the estimate.

    Giorno said after the sentencing that Shelburne could face as much as $700,000 in restitution if the U.S. Attorney General’s Office decides to pursue a civil case.

    An in-depth post-sentencing interview with Dr. Shelburne is here.

    In the meantime,

    • Dr. Shelburne has surrendered his Virginia dental license. A conviction, plus sentencing means it is revoked/forfeited anyway.
    • An appeal of his conviction has not been initiated, nor a decision made whether to appeal.
    • The United States Department of Justice will be appealing Judge Jones dismissal of seven federal felony money laundering counts against Shelburne to the United States Court of Appeals for the Fourth Circuit.
    • As far as Flap can discover, where Dr. Shelburne will spend his two years in prison and when he begins his sentence has not been announced.
    • Supporters and friends of Dr. Shelburne have created this site in order to support him.

    Stay tuned……

    Previous:

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court – Part Two

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed


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  • Dentistry,  Roy Shelburne

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court – Part Two

    roysshelburne

    Dr. Roy S. Shelburne of Virginia

    Flap yesterday reported that the money laundering convictions of Virginia dentist, Dr. Roy S. Shelburne, involving Medicaid fraud had been set aside by a federal judge.

    A federal judge on Tuesday overturned all seven money laundering convictions against a Pennington Gap, Va., dentist, which could set a precedent for how the government prosecutes such cases.

    In his order, James P. Jones, chief judge for the Western District of Virginia, upheld three convictions of Roy Silas Shelburne for racketeering, structuring a financial transaction and defrauding Medicaid. Jones’ reversal of the jury’s verdict on the money laundering convictions comes on the heels of a decision last month by the U.S. Supreme Court interpreting the statute, which set a higher burden for prosecutors alleging the offense.

    A jury’s convictions are evaluated in the light most favorable to the government, and Jones’ decision to vacate them underscored a substantial shift in the legal grounding of the case.

    “To say that I’m pleased with Judge Jones’ opinion in this matter would be an understatement,” said Dennis Jones, Shelburne’s attorney, who previously described the jury’s verdict as the “greatest miscarriage of justice” he had seen in his legal career.

    The judge’s order, he said Tuesday, “is significantly in keeping with what my understanding of the law was. He’s right on.”

    Dr. Shelburne continues to face considerable jeopardy with the three remaining felony convictions when he is sentenced on July 10th. He is considering an appeal.

    Undoubtedly, there will be new motions to set aside the three other convictions and to allow Dr. Shelburne bail pending appeal.

    However, even if the judge allows bail while the appeal is considered, Dr. Shelburne would have his dental license revoked during the appeal process.

    Flap bets there is a plea deal before the 10th which would allow Dr. Shelburne to continue to practice dentistry but under financial supervision for a period of time and the payment of a fine.

    The case appears thin and the federal prosecutors have definitley been slapped by the judge.

    Stay tuned……

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    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed


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  • Dentistry,  Roy Shelburne

    The Case of Dr. Roy S. Shelburne – 7 of 10 Counts Thrown Out of Court

    royshelburnefb8

    Dr. Roy S Shelburne and dental student (VCU) son Ross

    In a shocking reversal of fortune, Virginia dentist, Dr. Roy S. Shelburne had seven of his ten jury convictions for money laundering vacated today.

    In a stunning decision, a federal judge today vacated all seven jury convictions of a Pennington Gap, Va., dentist for money laundering.

    James P. Jones, chief judge for the Western District of Virginia, upheld three convictions of Roy Shelburne for racketeering, structuring a financial transaction and defrauding Medicaid.

    Jones’ opinion filed today pointedly rejected the government’s construction of the money laundering statute, which the U.S. Supreme Court interpreted last month, and highlighted the complexity of the case by setting aside seven of the jury’s convictions.

    Dr. Shelburne will be sentenced on the remaining three convictions on July 10. Obviously a United States Supreme Court decision on June 2nd affected the law in this case.

    Stay tuned…..

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    The Case of Dentist Dr. Roy S. Shelburne – Sentencing Postponed


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  • Criminals,  Dentistry,  Roy Shelburne

    The Case of Dentist Roy S. Shelburne

    Dr. Roy S Shelburne and dental student (VCU) son Ross

    Ok, what the FRAK is going on with this case?

    The press release of the dentist’s indictment is here.

    United States Attorney John L. Brownlee and Virginia Attorney General Bob McDonnell announced today that Roy Silas Shelburne, age 51, of Pennington Gap, Virginia, was indicted by a federal Grand Jury sitting in Abingdon, Virginia.

    Shelburne was charged in an eight count indictment with racketeering, healthcare fraud, mail fraud, wire fraud, money laundering, and interstate transportation of monies taken by fraud after a joint investigation by the Virginia Attorney General’s Medicaid Fraud Control Unit, the Internal Revenue Service, and the United States Attorney’s Office.

    “The Grand Jury has charged that Roy Shelburne was lining his own pockets by over billing Medicaid. Time after time, Medicaid was billed for services not performed, or services that were not needed,” said United States Attorney John Brownlee. “Shelburne gave no thought to the needs or the quality of care provided to his patients. In some cases, the work that was done was performed in such a manner that it was the equivalent of having no dental services performed at all.”

    A press account of Dr. Shelburne’s conviction is here.

    United States Attorney John L. Brownlee and Virginia Attorney General Bob McDonnell announced today that Roy Silas Shelburne, age 51, of Pennington Gap, Virginia, was found guilty today by a federal jury in Abington, Virginia, on all ten felony charges.

    “Roy Shelburne acted in a cruel and inhumane manner by performing unnecessary and extremely painful dental procedures on children. Shelburne’s criminal conduct towards these poor families and young foster children is one of the worst cases of abuse and fraud I have seen in my many years in law enforcement,” U.S. Attorney John L. Brownlee said today. “I am grateful that this jury held Mr. Shelburne responsible for his crimes. My thanks and gratitude go out to all the state and federal agents and prosecutors who worked tirelessly to bring the defendant to justice.”

    Key Graphs:

    • Beginning in 1998, Shelburne, who was a licensed dentist with a practice in Pennington Gap, executed a scheme to maximize his practice’s income by over billing insurance carriers and Medicaid for services that were never performed and for services that were performed, but not medically necessary.
    • In addition, Shelburne directed his employees to bill patients for services that were never performed or that were unnecessary. All of the patients Shelburne falsely billed were low income, underage patients who were recipients of Medicaid. A portion of the underage patients were residents of the Harvest Child Care Ministries group home.
    • According to the evidence presented at trial, Shelburne would “upcode” the bills for some of his patients. “Upcoding” is the process of performing one procedure but billing for a different procedure, one which requires a higher payment from Medicaid and private health insurance providers. In some cases, Shelburne would submit bills for services that were incomplete or medically unnecessary. At times, he performed services that endangered the health of his patients.
    • On several occasions Shelburne billed both Medicaid and private health insurance companies for services he performed in connection with a single procedure, collected money from both agencies and failed to reimburse either for the fraudulent fees he collected. Many times this created credit balances on the patients account that, according to his employees, Shelburne would simply “zero out” without reimbursing Medicaid.
    • According to the evidence presented at trial, Shelburne submitted at least 115 false billing statements by mail. The defendant took part of the fraudulently obtained funds and transferred them into a retirement account in Illinois. The evidence showed that Shelburne used some of the funds to build a new home known to his employees as the “Cavity Castle,” purchase luxury vehicles for himself and his family, and took his family on cruises that were deducted on his books as board expenses. In addition, he put his three children on the company payroll when, according to his employees, they provided no services. The salaries paid to the children were deducted as business expenses. Shelburne used part of the fraudulently obtained funds to pay his salary, purchase dental supplies and pay rent for his business and equipment.
    • In addition, Shelburne was convicted of structuring cash deposits at both BB&T Bank and Rick Hill Imports, a luxury car dealership, in an attempt to evade the currency transaction reporting requirements. With the structured funds, he contemporaneously purchased a used 2006 Mercedes SUV and a new 2006 Mercedes SLK coupe in the names of family members.
    • On cross-examination, Shelburne testified that the structured funds were part of a cash horde that he had accumulated to hide assets from investigators.

    But, now various “CLOSED – MEMBERSHIP ONLY” Dentist forums are ablaze with righteous indignation over Dr. Shelburne’s conviction. He is currently on bail awaiting sentencing on June 16th.

    A Florida dentist, Dr. Mike Barr has created a website to plead Dr.Shelburne’s case: Errant Medicaid Investigation Ruins Good Dentist.

    So, what is the story?

    Has there been a breakdown in the criminal justice system? Or is this merely a plea by a convicted felon that he did not commit the crimes? Or a convicted criminal attempting to drum up sympathy for a lighter sentence, new trial or a verdict set aside?

    Dr. Shelburne WAS indicted by a Federal Grand Jury and convicted by a jury. Yet, he and other dentists claim in numerous posts on the “closed sites” that he was treated unfairly?

    Stay tuned…….


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